Individual provider Active NPI

Fernando Edgardo Bermudez, MD

  • Diagnostic Radiology Physician
  • Sarasota, FL
National Provider Identifier
1548585102
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME124640 Issued in FL
Practice address
1700 S. Tamiami Trail
Sarasota, FL 34239-3555
Phone
(941) 917-7322
Fax
(813) 253-2299
NPI assigned
Apr 7, 2010
Last updated
Sep 30, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME124640 FL Primary

Addresses

Primary practice location

1700 S. Tamiami Trail
Sarasota, FL 34239-3555

Mailing address

2700 University Square Dr
Tampa, FL 33612-5513
Phone (813) 253-2721

Other identifiers 1

IdentifierTypeStateIssuer
015129900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1548585102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 UNIVERSITY SQUARE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336125513",
            "telephone_number": "813-253-2721",
            "fax_number": "813-253-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S. TAMIAMI TRAIL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342393555",
            "telephone_number": "941-917-7322",
            "fax_number": "813-253-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "FERNANDO",
        "middle_name": "EDGARDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-07",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME124640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015129900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.